Imaging Accessory Frame for Integration with an Operating Microscope

ABSTRACT

Some embodiments of the present inventive concept provide an accessory frame including an optical coherence tomography (OCT) imaging head. The accessory frame includes a mounting plate including a microscope field lens attachment port and a microscope field plate anchor pin. The mounting plate is configured to receive an intermediate field lens in the microscope field lens attachment port such that the accessory frame shares the mounting plate in common with an intermediate field lens.

CLAIM OF PRIORITY

The present application claims priority from U.S. ProvisionalApplication No. 61/426,192 (Attorney Docket No. 9526-36PR), filed onDec. 22, 2010, the disclosure of which is hereby incorporated herein byreference as if set forth in its entirety.

FIELD

The present inventive concept relates to imaging and, more particularly,to frames for use in the imaging process.

BACKGROUND

Surgical microscopes provide a magnified view of the operating field tothe surgeon. Ophthalmic surgical microscopes are commonly stereo zoommicroscopes with binocular view ports for the surgeon, and frequentlyhave one or two observer view ports at ninety degrees (left and right)to the surgeon. The working distance between the objective lens of themicroscope and the surface of a patient eye may range from about 100 mmto about 200 mm. At this working distance, which provides a suitablefield of access for the manual work of the surgeon, the field of viewwithin a patient eye may be quite limited. It is quite common to thenuse an intermediate lens, such as the Binocular Indirect OphthalmoMicroscope (BIOM) of Oculus Optikgerat, to modify the magnification andfield of view for the surgeon. This intermediate lens is mounted to theunder-carriage of the microscope head, and includes mechanics to adjustfocus, and to flip the lens into and out of the field of view of themicroscope.

Other illumination or imaging devices may also be used in the surgicalfield. Ideally, all illumination and imaging sources would be directlyintegrated coaxial to and within the optical path of the operatingmicroscope, without impacting the operating field for the surgeon, theobservers, the anesthesiologists, and the like. This is not alwayspossible. Without full integration as such, it is still desirable toprovide a readily maneuverable mount for imaging and other accessoriesthat is closely coupled to the surgical field, and the mechanicalcontrols and attributes that are already integral to a well-functioningoperating microscope.

A particular case of interest is the incorporation of optical coherencetomography (OCT) imaging into the surgical visualization practice. OCTprovides high resolution imaging of ocular tissue microstructure, and isshowing great promise to provide information to the surgeon that willimprove therapeutic outcomes, and reduce the total economic burdens ofsurgery by reducing risk and reducing re-work. The current generation ofOCT, known generally as Fourier Domain OCT, provides very fastvolumetric images (>30 mega-voxels per second) at very high resolution(2.0 μm to 6.0 μm axial resolution, 10.0 μm to 20 μm lateral resolution)particularly well suited to visualizing the fine tissue layers andmembranes that are often the subject of the surgical effort. In contrastto microscope visualization, OCT provides depth-resolved images,highlighting subsurface physiology and pathology, with full volumes overa 30 to 70 degree field of view acquired in about 1 to 3 seconds.However, the alignment requirements of OCT, particularly for retinaimaging, but also for cornea imaging, may be quite demanding to obtainhigh quality images. A flexible, finely controlled, and stable imagingplatform is desirable.

At present, there are no commercially available operating microscopeswith integrated OCT capabilities. The Assignee of the presentapplication has demonstrated handheld OCT imaging as discussed in, forexample, U.S. Patent Application Publication No. 2007/0081166 entitledPORTABLE OPTICAL COHERENCE TOMOGRAPHY (OCT) DEVICES AND RELATED SYSTEMS;U.S. Patent Application Publication No. 2009/0268020 entitled OPTICALCOHERENCE TOMOGRAPHY (OCT) IMAGING SYSTEMS FOR USE IN PEDIATRICOPHTHALMIC APPLICATIONS AND RELATED METHODS AND COMPUTER PROGRAMPRODUCTS; and U.S. Patent Application Publication No. 2009/0141237entitled INTEGRATED OPTICAL COHERENCE IMAGING SYSTEMS FOR USE INOPHTHALMIC APPLICATIONS AND RELATED METHODS AND COMPUTER PROGRAMPRODUCTS. Devices discussed therein are finding increasing utility inthe operative field. However, in some embodiments, the handheld devicemay be relatively difficult to align and stabilize for imaging in theoperating field.

Approaches have been established to address the stabilization issue. Forexample, one approach to stabilize a handheld probe is to use a simpleplanar mount coupled to the objective lens of the microscope. Thisdevice has a fixed armature length, and coarsely rotates around thelens. There are no height adjustments, and there is no ballast tocontrol torque on the microscope head. Another approach has been adoptedby Optovue. This approach uses an articulating arm attached to astructure other than the operating microscope. This approach lacks thefine control afforded by a well engineered operating microscope, andrisks being obstructive to the broader operating field. A third approachhas been to use an independent boom mount, with balance similar to anoperating microscope, as illustrated in, for example, U.S. Pat. No.8,064,989. This approach may add unnecessary bulk to the limited spaceof the operating theater.

SUMMARY

Some embodiments of the present inventive concept provide an accessoryframe including an optical coherence tomography (OCT) imaging head. Theaccessory frame includes a mounting plate including a microscope fieldlens attachment port and a microscope field plate anchor pin. Themounting plate is configured to receive an intermediate field lens inthe microscope field lens attachment port such that the accessory frameshares the mounting plate in common with an intermediate field lens.

In further embodiments, the accessory frame may be configured to bemountable such that rotation is to a left or a right of a surgeon.

In still further embodiments, the accessory frame may be configured torotate about 180 degrees on a half plane perpendicular to an opticalaxis to a left or a right of a surgeon.

In some embodiments, the accessory frame may be configured to rotate,such that when not in use, the mounted imaging head is about 180 degreesaway from a surgeon and about ninety degrees away from any observerstationed along a corresponding half plane.

In further embodiments, the accessory frame may be configured to rotate,such that when in use, a distance between a microscope optical axis andan independent imaging head optical axis is selected by a user.

In still further embodiments, the accessory frame may have a heightadjustment configured to position a distal surface of an imaging headobjective lens equal to or above a distal surface of a microscopeobjective lens.

In some embodiments, the accessory frame may have a height adjustmentconfigured to position a distal surface of an imaging head objectivelens at an appropriate working distance with respect to a patient eyefor proper imaging.

In further embodiments, the accessory frame may have a height adjustmentconfigured to accurately set a working distance from about 0.1 mm toabout 1.0 mm.

In still further embodiments, the accessory frame may include at leastsome sterilized or sterilizable materials suitable for use within asurgical sterile field.

In some embodiments, the accessory frame may include at least someautoclavable or disposable materials suitable for use within a surgicalsterile field.

In further embodiments, the accessory frame may further include debristraps configured to catch any materials that abrade from a structureduring motion, rotations and/or lifts while within a sterile field.

In still further embodiments, the accessory frame may be configured tobe maneuverable with or without the intermediate field lens in place,without requiring any interaction with the intermediate field lens.

In some embodiments, the accessory frame may further include at leastone point of rapid connect/disconnect to allow simple, single-handedremoval of either the entire frame or the mounted imaging head, withoutrequiring any interaction with the intermediate field lens.

In further embodiments, the accessory frame may further include aballast configured to balance a weight of the accessory frame includingthe imaging head, the ballast being applied to the half-plane oppositeof the mounting of the frame and imaging head.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are included to provide a furtherunderstanding of the inventive concept and are incorporated in andconstitute a part of this application, illustrate certain embodiment(s)of the inventive concept. In the drawings:

FIG. 1 is a diagram illustrating a surgical mount (accessory frame)including an optical coherence tomography (OCT) imaging head accordingto some embodiments of the present inventive concept.

FIG. 2 is a bottom view of the accessory frame of FIG. 1.

FIG. 3 is a perspective view of a mounting plate of the accessory framein accordance with some embodiments of the present inventive concept.

FIG. 4 is a bottom view of a mounting plate of the accessory frame inaccordance with some embodiments of the present inventive concept.

FIG. 5 is a diagram illustrating an anchor pin of an intermediate fieldlens assembly in accordance with some embodiments of the presentinventive concept.

FIG. 6 is a diagram illustrating an accessory frame quick connect plateand first rotation axle of the accessory frame in accordance with someembodiments of the present invention.

FIG. 7 is a diagram illustrating an instrument carriage of the accessoryframe in accordance with some embodiments of the present invention.

FIGS. 8 and 9 are diagrams illustrating upper and lower portions of adebris trap of the accessory frame in accordance with some embodimentsof the present invention.

FIG. 10 is a diagram illustrating a second rotation axle and a rotationaxle bridge of the accessory frame in accordance with some embodimentsof the present invention.

FIG. 11 is a diagram illustrating an instrument carriage quick connectinstrument mount of the accessory frame in accordance with someembodiments of the present invention.

FIG. 12 is a diagram illustrating an elevation wheel of the accessoryframe in accordance with some embodiments of the present invention.

FIGS. 13 and 14 are diagrams illustrating portions of the instrumentcarriage quick connect instrument mount in accordance with someembodiments of the present invention.

FIG. 15 is block diagram illustrating the placement of the mount to theundercarriage of the microscope imaging body in accordance with someembodiments of the inventive concept.

FIG. 16 is a block diagram illustrating a position of an imaging headwith respect to the body of the microscope in accordance with someembodiments of the present inventive concept.

FIG. 17 is a diagram illustrating accessory frames in accordance withsome embodiments of the present inventive concept.

DETAILED DESCRIPTION

The inventive concept will now be described more fully hereinafter withreference to the accompanying drawings, in which embodiments of theinventive concept are shown. This inventive concept may, however, beembodied in many different forms and should not be construed as limitedto the embodiments set forth herein; rather, these embodiments areprovided so that this disclosure will be thorough and complete, and willfully convey the scope of the inventive concept to those skilled in theart.

It will be understood that, when an element is referred to as being“connected” to another element, it can be directly connected to theother element or intervening elements may be present. In contrast, whenan element is referred to as being “directly connected” to anotherelement, there are no intervening elements present. Like numbers referto like elements throughout.

Spatially relative terms, such as “above”, “below”, “upper”, “lower” andthe like, may be used herein for ease of description to describe oneelement or feature's relationship to another element(s) or feature(s) asillustrated in the figures. It will be understood that the spatiallyrelative terms are intended to encompass different orientations of thedevice in use or operation in addition to the orientation depicted inthe figures. For example, if the device in the figures is turned over,elements described as “below” other elements or features would then beoriented “above” the other elements or features. Thus, the exemplaryterm “below” can encompass both an orientation of above and below. Thedevice may be otherwise oriented (rotated 90 degrees or at otherorientations) and the spatially relative descriptors used hereininterpreted accordingly. Well-known functions or constructions may notbe described in detail for brevity and/or clarity.

It will be understood that, although the terms first, second, etc. maybe used herein to describe various elements, these elements should notbe limited by these terms. These terms are only used to distinguish oneelement from another. For example, a first element could be termed asecond element, and, similarly, a second element could be termed a firstelement, without departing from the scope of the present inventiveconcept. As used herein, the term “and/or” includes any and allcombinations of one or more of the associated listed items.

Unless otherwise defined, all terms (including technical and scientificterms) used herein have the same meaning as commonly understood by oneof ordinary skill in the art to which this inventive concept belongs. Itwill be further understood that terms, such as those defined in commonlyused dictionaries, should be interpreted as having a meaning that isconsistent with their meaning in the context of this specification andthe relevant art and will not be interpreted in an idealized or overlyformal sense expressly so defined herein.

Embodiments of the inventive concept are described herein with referenceto schematic illustrations of idealized embodiments of the inventiveconcept. As such, variations from the shapes and relative sizes of theillustrations as a result, for example, of manufacturing techniquesand/or tolerances, are to be expected. Thus, embodiments of theinventive concept should not be construed as limited to the particularshapes and relative sizes of regions illustrated herein but are toinclude deviations in shapes and/or relative sizes that result, forexample, from different operational constraints and/or frommanufacturing constraints. Thus, the elements illustrated in the figuresare schematic in nature and their shapes are not intended to illustratethe actual shape of a region of a device and are not intended to limitthe scope of the inventive concept.

As discussed above, alignment requirements of optical coherencetomography (OCT), particularly for retina imaging, but also for cornealimaging, may be quite demanding to obtain high quality images. Thus, aflexible, finely controlled, and stable imaging platform is desirable.Accordingly, some embodiments of the present inventive concept provide amounting frame, alignment, and stabilization system that allows anindependent imaging system, such as an OCT imaging head, which will bediscussed further below with respect to FIGS. 1 through 14.

Referring first to FIG. 1, diagram illustrating a surgical mount(accessory frame) including an optical coherence tomography (OCT)according to some embodiments of the present inventive concept will bediscussed. As illustrated in FIG. 1, the accessory frame 190 includes amounting plate 100, an accessory frame quick connect plate 110, a firstrotation axle 120, a second rotation axle with riser 130, an instrumentcarriage 140, an instrument carriage quick connect instrument, mount150, an imaging head 160, a′ debris trap 122, an elevation wheel 132, afirst rotation lock 124, a second rotation lock 134, an accessory framequick connect lock 102, a rotation axle bridge 170, a microscope fieldlens attachment port (dovetail) 105, a microscope field lens anchorpin/ballast 180, a ballast lock 104 and imaging head lens 165. FIG. 2 isa bottom view of the accessory frame 190 of FIG. 1. Details of many ofthe aspects of the accessory frame of FIGS. 1 and 2 will be discussedfurther below with respect to FIGS. 3 through 10. It will be understoodthat embodiments of the present inventive concept are not limited to thedetails illustrated in FIGS. 1 and 2. Features may be added or deletedwithout departing from the scope of the present inventive concept.

As discussed above, improvements in the area of frames and the like aredesired. Accessory frames 190 in accordance with some embodiments of thepresent inventive concept may share a mounting plate in common with anintermediate field lens. In particular, as illustrated in FIG. 1, themounting plate 100 includes a microscope field lens attachment port 105.This feature of the mounting plate 100 may be clearer in the enlargedperspective view of the mounting plate 100 illustrated in FIG. 3. FIG. 4is a diagram illustrating an underside of the mounting plate 100. Thus,an intermediate field lens may be mounted to the accessory frame 190using the field lens attachment port 105 of the mounting plate 100.

Referring to FIG. 15, a diagram illustrating the placement of the mount300 (100 in FIG. 1) to the undercarriage of the microscope imaging body201 will be discussed. As illustrated therein, the field lens assembly300 includes the dovetail plate 302, and armature 301 that holds areducing lens 304 and a final objective in the field between themicroscope objective 202 and the subject 400. Other optical assembliesmay be used mounted to the carriage 302 without departing from the scopeof the present inventive concept.

Referring now to FIG. 16, a diagram illustrating a position of animaging head with respect to the body of the microscope will bediscussed. As illustrated in FIG. 16, in these embodiments, the OCTimaging path is not coaxial with the microscope head in conjunction withthe rotation. Furthermore, lift capabilities of the accessory frame maybe used to align the OCT imaging path to the subject.

Accessory frames in accordance with some embodiments may be mountablesuch that rotation is to the left or the right of a surgeon and mayrotate approximately 180 degrees on a half plane perpendicular to theoptical axis to the left or the right of the surgeon.

Furthermore, when not in use, the mounted head may be rotatedapproximately 180 degrees away from the surgeon, and approximatelyninety degrees away from any observer stationed along the correspondinghalf plane. However, when in use the distance from the microscopeoptical axis and the independent imaging head optical axis may bedetermined by a user thereof.

The accessory frame 190 may have a height that can be adjusted toposition a distal surface of an imaging head objective lens equal to orabove a distal surface of the microscope objective lens. The height mayalso be adjusted to position the distal surface of the imaging headobjective lens at an appropriate working distance with respect to thepatient eye for proper imaging. As used herein, “an appropriate workingdistance” refers to the distance from the distal most surface of the OCTimaging head including lens to the proximal most surface of the subject,with the intent of providing adequate visualization of the subject and,when necessary, adequate physical access to the subject.

In some embodiments, the height adjustment may be used to set theworking distance to from about 5.0 mm to about 100 mm.

Some embodiments of the accessory frame 190 may be constructed of atleast some sterilized or sterilizable materials suitable for use withinthe surgical sterile field. Furthermore, in some embodiments at leastsome autoclavable or disposable materials suitable for use within thesurgical sterile field may be used.

As illustrated in FIG. 1 and further discussed with respect to FIGS. 8and 9, the accessory frame may include debris traps to catch anymaterials that may abrade from the structure during motion, rotations,lifts, and the like, while within a sterile field.

Some embodiments of the present inventive concept are configured to bemaneuverable with or without the intermediate field lens in place,without requiring any interaction with the intermediate field lens.

The accessory frame 190 may have one or more points of rapidconnect/disconnect to allow simple, and in some embodiments,single-handed removal of either the entire frame or the mounted imaginghead, without requiring any interaction with or disruption of theintermediate field lens assembly.

As further illustrated in FIG. 1, the accessory frame includes a ballast180 to balance the weight of the frame plus the imaging head. Theballast 180 may be applied to the half-plane opposite of the mounting ofthe frame and imaging head. The ballast may be weighted such that thetorque applied by the frame and imaging head is offset by the ballast.

Referring now to FIG. 5, a diagram illustrating an anchor pin 102 of anintermediate field lens assembly in accordance with some embodiments ofthe present inventive concept will be discussed. As illustrated in. FIG.1, the anchor pin 102 (accessory frame quick connect lock) connects themounting plate 100 to the accessory frame quick connect plate 110, whichis illustrated in FIG. 6. As illustrated in FIG. 6, the accessory framequick connect plate 110 is connected to the first rotation axle 120. Theanchor pin 102 and all such like devices that are part of the framesystem, may be mechanically captive, such that the pin can release theconnection to the frame without coming free of the mounting plate.

FIG. 7 is a diagram illustrating an instrument carriage 140 of theaccessory frame in accordance with some embodiments of the presentinvention. As illustrated in FIG. 1, the second rotations axle 130extends through the instrument carriage 140, the elevation wheel 132(illustrated in FIG. 12), and the instrument carriage quick connectmount 150 to the rotation axle bridge 170.

FIGS. 8 and 9 are diagrams illustrating upper and lower portions of adebris trap of the accessory frame in accordance with some embodimentsof the present invention. As illustrated in FIG. 1, the upper and lowerportions of the debris trap 122 are separated by the rotation axlebridge 170 and the first rotation axle 120 extends through the upper andlower portions of the debris trap 122.

FIG. 10 is a diagram illustrating the second rotation axle 13—and therotation axle bridge 170 of the accessory frame in accordance with someembodiments of the present invention.

FIG. 11 is a diagram illustrating an instrument carriage quick connectinstrument mount 150 of the accessory frame in accordance with someembodiments of the present invention. As illustrated in FIG. 11, theinstrument carriage quick connect instrument mount 150 has first 150 andsecond 151 portions. These portions 150, 151 are connected to theinstrument carriage 140 and the second rotation lock 134.

FIGS. 13 and 14 are diagrams illustrating portions of the instrumentcarriage quick connect instrument mount 150 in accordance with someembodiments of the present invention. In particular, FIG. 13 illustratesthe second portion 151 of the instrument mount and FIG. 14 illustrates afront view of the attachment port thereof.

Referring now to FIG. 17, a block diagram illustrating frameconstruction in accordance with some embodiments will be discussed. Theframe construction illustrated therein incorporates the OCT imaging headin such a way as to interject the scanning OCT into the path of thesurgical microscope, such that the OCT signal shares the surgicalmicroscope objective 202, and the OCT signal and the surgical imagingfield are substantially coaxial. In these embodiments, the OCT imaginghead is connected to the mounting carriage similarly to the manner inwhich the accessory frame would be connected to the mounting carriage.The microscope objective is removed from the body of the microscope andattached to the underbody of the OCT imaging head.

In the drawings and specification, there have been disclosed exemplaryembodiments of the invention. However, many variations and modificationscan be made to these embodiments without substantially departing fromthe principles of the present invention. Accordingly, although specificterms are used, they are used in a generic and descriptive sense onlyand not for purposes of limitation, the scope of the invention beingdefined by the following claims.

1. An accessory frame including an optical coherence tomography (OCT)imaging head, the accessory frame comprising: a mounting plate includinga microscope field lens attachment port and a microscope field plateanchor pin, the mounting plate being configured to receive anintermediate field lens in the microscope field lens attachment portsuch that the accessory frame shares the mounting plate in common withan intermediate field lens.
 2. The accessory frame of claim 1, whereinthe accessory frame is configured to be mountable such that rotation isto a left or a right of a surgeon.
 3. The accessory frame of claim 1,wherein the accessory frame is configured to rotate about 180 degrees ona half plane perpendicular to an optical axis to a left or a right of asurgeon.
 4. The accessory frame of claim 1, wherein the accessory frameis configured to rotate, such that when not in use, the mounted imaginghead is about 180 degrees away from a surgeon and about ninety degreesaway from any observer stationed along a corresponding half plane. 5.The accessory frame of claim 1, wherein the accessory frame isconfigured to rotate, such that when in use, a distance between amicroscope optical axis and an independent imaging head optical axis isselected by a user.
 6. The accessory frame of claim 1, wherein theaccessory frame has a height adjustment configured to position a distalsurface of an imaging head objective lens equal to or above a distalsurface of a microscope objective lens.
 7. The accessory frame of claim1, wherein the accessory frame has a height adjustment configured toposition a distal surface of an imaging head objective lens at anappropriate working distance with respect to a patient eye for properimaging.
 8. The accessory frame of claim 1, wherein the accessory framehas a height adjustment configured to accurately set a working distancefrom about 0.1 mm to about 1.0 mm.
 9. The accessory frame of claim 1,wherein the accessory frame includes at least some sterilized orsterilizable materials suitable for use within a surgical sterile field.10. The accessory frame of claim 1, wherein the accessory frame includesat least some autoclavable or disposable materials suitable for usewithin a surgical sterile field.
 11. The accessory frame of claim 1,further comprising debris traps configured to catch any materials thatabrade from a structure during motion, rotations and/or lifts whilewithin a sterile field.
 12. The accessory frame of claim 1, wherein theaccessory frame is configured to be maneuverable with or without theintermediate field lens in place, without requiring any interaction withthe intermediate field lens.
 13. The accessory frame of claim 1, whereinthe accessory frame further comprises at least one point of rapidconnect/disconnect to allow simple, single-handed removal of either theentire frame or the mounted imaging head, without requiring anyinteraction with the intermediate field lens.
 14. The accessory frame ofclaim 1, wherein the accessory frame further includes a ballastconfigured to balance a weight of the accessory frame including theimaging head, the ballast being applied to the half-plane opposite ofthe mounting of the frame and imaging head.